complex RCA intervention in post CABG patient.

post cabg pt. symptomatic.
occluded svgs, patent Lima.
rca calcified diffuse disease. LCX tight ostia stenosis and tight lesion of OM.
pci to rca planed.
difficult guide engagement. pressure dampening with engagement.
JR4 SH used , difficult balloon crossing. proximal lesion predil with high pressure nc . guide extension used. balloon 1.0 reptured, 2nd 1.0 then 1.5 mm reptured.
gernadoplasty. BAT for guide extension tracking. 2.0 nc then used. extensive predil with multiple NC. stenting until ostium. post dil. TIMI III flow achieved.

[@abdulraufsheikh7470]

Excellent result. What was the clinical indication to do PCI of non dominant RCA?

[@drimranhanifhashmi5442]

Dominant rca system. Actually co Dominant system.
Effort angina despite of GDMT.
Plan to do staged pci of lms lcx and pm

[@MinorityDoc]

Tusi great ho 🙏🏼

[@ismailmohamed2020]

Excellent result my dear prof , please can you explain the PCI steps of this case in brief